{ "abstract": "Emerging constraints across healthcare systems are driving the need for wearable digital health technologies capable of supporting patient monitoring in remote and extreme environments. 1 Advances in materials science and flexible electronics, including miniaturized sensors, low power systems, and edge AI, are enabling autonomous, real time physiological monitoring.2 Yet, widespread clinical adoption is still limited by the lack of high-quality, real-world data validating system performance.3 In defense applications, the demand for these innovations is intensified by the realities of modern conflict. Lessons from the Ukraine war highlight the prevalence of contaminated wounds, traumatic amputations, and delays in accessing advanced care. To meet the needs of prolonged field care and prehospital trauma management, modular and portable platforms must support diagnostics, haemorrhage control, resuscitation, endovascular stabilization, analgesia, organ support, blood substitution, and burn and wound care. Continuous physiological monitoring, beyond the ‘golden hour’, is critical for timely intervention and improved survival outcomes.Promising configurations using advanced materials and hybrid printed electronics (HPE) show potential for wound healing,4 bacterial detection,5 and continuous monitoring in extreme conditions. However, unresolved challenges remain, including motion artifacts, sensor drift, and integration issues affecting wearability and durability.6–8 While academic developments demonstrate technological capabilities, many overlook real world deployment needs.There is an increasing need for lightweight, disposable, standalone wearable systems that can be rapidly deployed and resupplied. These technologies can enhance triage, casualty management, and wound care by delivering real time insights in constrained environments.9 TNO has been conducting exploratory studies to integrate sensor systems for vital sign monitoring and smart wound care into hybrid printed electronic (HPE) designs. Preliminary findings demonstrate promising levels of accuracy, sensitivity, and long-term durability. The investigated sensing modalities include physical sensors, such as temperature and pressure, for monitoring inflammation, perfusion, and thermoregulation; optical sensors for assessing vascularity, tissue oxygenation, and microcirculatory status; and chemical and biological sensors for detecting pH shifts, bacterial load, and infection-related biomarkers (figure 1).In addition, these sensor systems show potential for evaluating broader physiological parameters such as hydration levels and stress responses. This could enable more comprehensive and adaptive health assessment in dynamic, resource-constrained environments. These integrated sensing platforms aim to support earlier and more targeted interventions. Further development of defense specific designs could accelerate real world data collection and advance adoption in both military and civilian healthcare.HPE technologies provide a scalable, adaptable platform for embedding sensor functionality into wearable patches and smart wound management. Customizable to mission needs, these systems can incorporate battery-less communication, sensor multiplexing, and optimized layouts, offering compact, deployable tools to improve frontline care and medical decision making in high risk, resource limited environments.References World Health Organisation, ‘Health Workforce’ https://www.who.int/health-topics/health-workforce#tab=tab_1.B. Srinivasaiah, 2022, Transformative wearables; how AI and ML are shaping healhtcare innovations. International Journal of Science and Research (IJSR). 2319–7064Zou KH, Berger ML. Real-world data and real-world evidence in healthcare in the United States and Europe union. Bioengineering (Basel). 2024 Aug 2;11(8):784. doi: 10.3390/bioengineering11080784. PMID: 39199742; PMCID: PMC11351410.Freedman BR, Hwang C, Talbot S, Hibler B, Matoori S, Mooney DJ. Breakthrough treatments for accelerated wound healing. Sci Adv. 2023 May 19;9(20):eade7007. doi: 10.1126/sciadv.ade7007. Epub 2023 May 17. PMID: 37196080; PMCID: PMC10191440Mohamed Salleh NAB, Tanaka Y, Sutarlie L, Su X. Detecting bacterial infections in wounds: a review of biosensors and wearable sensors in comparison with conventional laboratory methods. The Analyst. 2022;147(9):1756–1776. https://doi.org/10.1039/d2an00157hO. Such, ‘Motion tolerance in wearable sensors – The challenge of motion artifact,’ 2007 29th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, Lyon, France, 2007, 1542–1545, doi: 10.1109/IEMBS.2007.4352597Fruytier LA, Janssen DM, Campero Jurado I, van de Sande DA, Lorato I, Stuart S, Panditha P, de Kok M, Kemps HM. The utility of a novel electrocardiogram patch using dry electrodes technology for arrhythmia detection during exercise and prolonged monitoring: proof-of-concept study. JMIR Formative Research 2023;7:e49346.Stuart S, de Kok M, O’Searcoid B, Morrisroe H, Serban IB, Jagers F, Dulos R, Houben S, van de Peppel L, van den Brand J. Critical design considerations for longer-term wear and comfort of on-body medical devices. Bioengineering (Basel, Switzerland). 2024;11(11):1058. https://doi.org/10.3390/bioengineering11111058Hegarty-Craver M, Davis-Wilson H, Gaur P, et al. Wearable sensors for service members and first responders: considerations for using commercially available sensors in continuous monitoring. Research Triangle Park (NC): RTI Press. 2024.Abstract P08 Figure 1TNO Smart wound care portfolio for current integration of sensors within dressings and conformability of electronics for wearable patches", "authors": [ { "affiliations": [ "Netherlands Organization for Applied Scientific Research (TNO), Holst Centre, Unit High Tech Industry, Eindhoven, The Netherlands" ], "name": "Shavini Stuart" }, { "affiliations": [ "Netherlands Organization for Applied Scientific Research (TNO), Department of Human Performance, Unit Defense, Safety and Security, Soesterberg, The Netherlands" ], "name": "Lotte Linssen" }, { "affiliations": [ "Netherlands Organization for Applied Scientific Research (TNO), Department of Human Performance, Unit Defense, Safety and Security, Soesterberg, The Netherlands" ], "name": "Kaj Gilbertse" }, { "affiliations": [ "Netherlands Organization for Applied Scientific Research (TNO), Optics, Unit High Tech Industry, Delft, The Netherlands" ], "name": "Arjen Amelink" }, { "affiliations": [ "Netherlands Organization for Applied Scientific Research (TNO), Health and Work, Leiden, The Netherlands" ], "name": "Willem van den Brink" }, { "affiliations": [ "Netherlands Organization for Applied Scientific Research (TNO), Health and Work, Leiden, The Netherlands" ], "name": "Suzan Wopereis" }, { "affiliations": [ "Netherlands Organization for Applied Scientific Research (TNO), CBRN, Unit Defence, Safety and Security, Leiden, The Netherlands" ], "name": "Freek van t’Hoen" }, { "affiliations": [ "Netherlands Organization for Applied Scientific Research (TNO), Holst Centre, Unit High Tech Industry, Eindhoven, The Netherlands" ], "name": "Natallia Uzunbajakava" }, { "affiliations": [ "Netherlands Organization for Applied Scientific Research (TNO), Department of Human Performance, Unit Defense, Safety and Security, Soesterberg, The Netherlands" ], "name": "Boris Kingma" }, { "affiliations": [ "Netherlands Organization for Applied Scientific Research (TNO), Holst Centre, Unit High Tech Industry, Eindhoven, The Netherlands" ], "name": "Jayeeta Sengupta" }, { "affiliations": [ "Netherlands Organization for Applied Scientific Research (TNO), Holst Centre, Unit High Tech Industry, Eindhoven, The Netherlands" ], "name": "Onno Huiskamp" }, { "affiliations": [ "Netherlands Organization for Applied Scientific Research (TNO), Holst Centre, Unit High Tech Industry, Eindhoven, The Netherlands" ], "name": "Jeroen van den Brand" } ], "title": "P08 Towards smart medical wearables for defense: lessons from the frontlines", "uid": "1977eb07-6a9a-58d5-9446-5b48aeae738b" }